Uninsured Visits to Community Health Centers Down Post-ACA

(HealthDay News) — There was a 40% drop in uninsured visits to community health centers in states where Medicaid was expanded during the first half of 2014, when compared to the prior year, while Medicaid-covered visits to those clinics rose 36%, according to new research. The findings were published in the January/February issue of the Annals of Family Medicine.

Jennifer DeVoe, MD, DPhil, an associate professor of family medicine at the Oregon Health & Science University in Portland, and colleagues included 156 health centers in nine states – five that expanded Medicaid and four that did not – and 333,655 adult patients. Of the five Medicaid expansion states in the study, one state, Oregon, accounted for a majority of the clinics and patient visits. Because the sample was limited, the findings may not reflect what's occurring in all states or at all health centers, the authors acknowledged in the report.

The researchers found that clinics in the expansion states had a 40% decrease in the rate of uninsured visits in the postexpansion period and a 36% increase in the rate of Medicaid-covered visits. In states that did not expand Medicaid, there was no change in the rate of health centers' Medicaid-covered visits and a smaller decline, just 16%, in the rate of uninsured visits.

"If you look at health insurance claims, uninsured visits and uninsured patients are completely invisible. They don't show up anywhere," DeVoe, who also serves as OCHIN's chief research officer, told HealthDay. OCHIN (Oregon Community Health Information Network) is a nonprofit collaboration of public and private health systems in Oregon. "This allows them to become visible and gives us a more complete picture of the entire patient population, both during periods of uninsurance and periods of insurance."